Temporomandibular joint disorders (TMDs) comprise a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ), masticatory muscles, and associated structures. While most patients respond favorably to conservative therapies, a subset develops persistent symptoms requiring surgical intervention. Surgical management ranges from minimally invasive procedures such as arthrocentesis and arthroscopy to open joint surgeries and total joint replacement. This review examines the indications, surgical techniques, clinical outcomes, complications, and future advancements in the surgical management of TMJ disorders. Current evidence indicates that appropriately selected patients experience significant improvements in pain reduction, mandibular function, joint mobility, and quality of life following surgical intervention. Advances in digital planning, three-dimensional imaging, patient-specific prostheses, and regenerative medicine continue to enhance treatment predictability and long-term outcomes.